How has the therapeutic use of self been used over time throughout Occupational Therapy’s history?
“Difficult, but important”
Reflection is an important yet ethereal skill that all Occupational Therapists need to master.
Part of completing a reflection is an inner sense of discomfort (in fact the first stage of reflection as described by Boyd & Fales 1983) so it’s no wonder many people put it off and may even try to get by without it, perhaps carrying out token reflections just to comply with CPD or course requirements. To begin with, reflecting on your actions is something that requires conscious effort after the event but eventually, according to Johns (2000), it will become an automatic thought process even when you’re in the middle of experiencing the event. When deciding which model to use, it can helpful to find out what learning style you are according to Honey & Mumford. You can relate these to the knowledge types shown in Carper/Johns’ reflective models.
Below is a rough guide to the different models of reflection out there, and which situations they’re best geared towards. They are ordered (in my opinion) from the easier ones for the beginner who is trying to break down and evaluate a situation, to the more complex ones that build on the basics and hope to elicit a change in your personal beliefs and challenge your assumptions. Gillie Bolton suggests exercises for creative ways to reflect in her book Reflective Practice: Writing and Professional Development (chapter 4).
Like Inception, you’ll naturally find yourself going deeper with your analysis of an event the more experience you gain with reflective models. Enjoy the ride!
Gibbs reflective cycle (1988)
Good for: Good old Gibbs. Basic, good starting point, six distinctive stages. Makes you aware of all the stages you go through when experiencing an event.
Criticisms are: superficial reflection- no referral to critical thinking/analysis/assumptions or viewing it from a different perspective (Atkins & Murphy 1993). Does not have the number or depth of probing questions as other models.
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The OT process is when we apply the theories of occupation in an ordered way to a practical situation. Many different models of the OT process have been developed, and they each attempt to guide a therapist through the stages of applying occupational theory to a practical client situation. Some models may be more useful in particular situations or with particular clients than others.
Part of the artistry of an being an OT, and the difference between being a technician and a professional, is being able to adopt a holistic approach and use a model most appropriate to the individual client’s unique blend of problems in order to achieve a positive outcome. Technicians follow instruction in order to carry out processes whereas professionals use a blend of artistry with science to determine the best model and interventions for each unique patient.
Some examples of OT process models are below:
- PEOP Person-Environment-Occupational Performance
- CMOP-E Canadian Model of Occupational Performance & Engagement
- MOHO Model of Human Occupation
- MoCA Model of Creative Ability
- Biopsychosocial model
- Max Neef model
- Capability approach
- Medical model
- Kawa (river) model
- Social disability model
- European Conceptual Framework for Occupational Therapy
- EHP Ecology of Human Performance
- OA Occupational Adaptation model
- OPM(A) Occupational−Performance Model (Australia)